Therapies and Treatments

Adrenal, Cortisol Energy Assessments

People often ask to have their hormones tested. This is a great question, but it requires some skill to determine exactly what to test and the timing during the month to do the test. Blood tests show a single reading and hormones fluctuate through the day and if you are using topical hormone replacement it isn't always the most accurate. I prefer to use the DUTCH Comprehensive Hormone panel that measures urinary hormone metabolites and is an excellent way of assessing imbalances in your sex hormones including estrogen, progesterone and testosterone and your adrenal hormones including cortisol and DHEA. Four samples are taken throughout the day and averaged so your true daily hormone totals are more accurate. It can also identify circadian rhythms by measuring your cortisol output overnight, rising and during the day. This give significantly more information than a single morning serum level.

At A Natural Choice we pride ourselves on providing a personalized assessment and prescription, not a “cookie cutter” approach that is the same for everyone. To assess your hormones, we utilize an extensive questionnaire and interview process, DUTCH urine hormone testing, comprehensive blood tests, and diet and lifestyle assessments to determine a customized protocol that fits your body’s specific needs.

Here are some reasons we might want to do the Comprehensive DUTCH panel.

1) Identify if hormonal imbalances are the a potential cause of your symptoms. If you are menopausal we can run this test at any time during the month. If you are still cycling, then for a woman with a 28 day cycle we try to gather the samples around day 20 of your cycle. Day 1 is the day your period starts.

2) Determine the safety of hormone replacement therapy specifically for you. Some women have higher levels of estrogen and in those situations, hormone replacement is inappropriate and dangerous. Other women have low estrogen, but even lower progesterone so a combination therapy is more essential.

3) Determine the safety and dosing of your hormone replacement therapy. The DUTCH panel will identify how you metabolize your hormones and if you require nutritional supplementation to make sure you don't preferentially metabolize your hormones down a pathway that leads to increased risk of uterine and breast cancer.

4) Annually monitor your hormone levels and metabolism of your hormones. Bio-identical replacement therapy is still an estrogen and so it inherently carries risks. Monitoring not only your levels but your metabolism is key to minimizing those risks.

5) Assess your total output of cortisol and DHEA to identify if your adrenal glands are contributing to your symptoms. If you cortisol is too high or too low it can lead to a myriad of symptoms. Read below and click here for more information on the adrenal glands. Adrenal Glands, The Stress Adapting Gland

6) Assess your circadian rhythm and communication between you pituitary and adrenal glands, and your HPA Axis. If you circadian rhythm or HPA axis is disrupted; insomnia, restless sleep and waking unrefreshed will often occur.

7) Assess DHEA and testosterone levels and metabolism of the androgen or males hormones in both men and women. If you are metabolizing down the more "androgenic" pathways then men are more likely to have enlarged prostates and both men and women are more likely to have hormone induced hair loss.

8) Assess melatonin levels, B12 levels, oxidative stress and antioxidant support.

Here is a video on how to do the DUTCH comprehensive Hormone Panel. DUTCH Hormone Test Instructions

During a 24 hour period, cortisol typically peaks in the early morning and drops dramatically as the day progresses. This higher morning, lower evening and lowest throughout the night, indicates a good circadian rhythm. Ideally cortisol should drop to 10% of its level by evening. A healthy adrenal gland replenishes cortisol during sleep and you feel refreshed in the morning. I wrote an article Adrenals, The Stress Adapting Gland where you can get more information and find help for your tired adrenals, but here is a summary of what adrenal dysfunction can cause:

1) Difficulty rising in the morning or energy slumps during the day
2) Reduced tissue repair and increased tissue breakdown lending to muscle and joint pain
3) Compromised bone rebuilding and an increased risk of Osteoporosis
4) Suppressed immune response so you succumb to illness easily
5) Poor adaptation to stress
6) Weight gain, especially around the waist
7) Lowered ability to enter REM sleep leading to reduced vitality and depression
8) Less skin regeneration
9) Hypothyroid symptoms

If you have questions or you would like set up a personal evaluation, call or email today and begin your journey to feeling amazing 360-573-2273 or